Once you know that you have an abscessed tooth, a decision has to be made. An abscess is an active infection, so it can’t be left untreated, because it will affect the level of health for your whole body.
Unfortunately, not all infected teeth are treatable. When a tooth is rotten or broken down to or even below the surrounding bone level, it is not restorable, so needs to be removed. But what if more than enough solid tooth is left to work with? Other factors now need to be considered.
If the tooth is the last one in the row at the back of the mouth and all the other teeth are present, some patients don’t feel that this back tooth is worth the time trouble or expense to keep. Since it’s their mouth, after discussing their decision I will agree to the extraction. Also if a person is already missing many teeth, saving one doesn’t make much sense, unless it is important to make a partial denture more comfortable and stable. Other people who have already lost several teeth will say, “This has got to stop”, and go to great lengths to save every one of the few left.
Cost can be a factor in the decision process. The cost of a root canal treatment and the necessary crown on a molar is almost as much as an extraction and a permanent bridge to fill the space. The long-term success of a bridge may be more predictable than that of a root canal treated tooth. Because of the uncertainties in predicting the future, some people will opt for extraction and an implant for the replacement. This route eliminates the root canal treatment, with its approximately 90% success rate, and also removes possible complications caused by crowning two teeth to support a permanent bridge. Implant-supported teeth are not fail proof either, but you are not risking any other teeth with this treatment.
As you see, whether or not to treat or remove an abscessed tooth is not always a straightforward decision. Many factors come to play in making the decision. As with any procedure involving one’s health, the outcome and consequences are not precisely known and we can only hope to weigh them in your favour.